Individual provider Active NPI

Allen Koichi Tomoeda, OD

  • Optometrist
  • Aurora, CO
National Provider Identifier
1447234661
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9993899 Issued in CO
Practice address
6201 S Aurora Pkwy
Aurora, CO 80016-5849
Phone
(303) 617-5620
Fax
(303) 617-5622
NPI assigned
Dec 1, 2005
Last updated
Jul 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9993899 CO Primary

Addresses

Primary practice location

6201 S Aurora Pkwy
Aurora, CO 80016-5849

Mailing address

6201 S Aurora Pkwy
Aurora, CO 80016-5849
Phone (303) 617-5620

Other identifiers 1

IdentifierTypeStateIssuer
08009383MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210917002855 FL Practitioner - Optometry 3375709322 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9993899COMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Sep 8, 2021 Accepting new patients
National Vision Inc Optometrist CurrentSince Jun 29, 2025 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Sep 8, 2021 Accepting new patients
Wisconsin Vision, LLC Optometrist Past Accepting new patients
Wisconsin Vision, LLC Optometrist PastSince Jun 15, 2021 Accepting new patients

Locations

4090 S Parker Rd
Ste Ab
Aurora, CO 80014
Phone (720) 533-3825

2140 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 926-9213

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1447234661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 S AURORA PKWY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165849",
            "telephone_number": "303-617-5620",
            "fax_number": "303-617-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 S AURORA PKWY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165849",
            "telephone_number": "303-617-5620",
            "fax_number": "303-617-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMOEDA",
        "first_name": "ALLEN",
        "middle_name": "KOICHI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "9993899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08009383",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.